For the mentally ill behind bars in Montana, life goes from bad to worse

Colton Wilson has a tombstone tattooed on his right forearm. On a recent late-winter day, the 21-year-old moves constantly inside the visitor center at Shelby's Crossroads Correctional Facility. He picks at his fingers, clenches his hands and shifts his feet. He runs his hands through his dark, wavy hair.

The worst part of prison, he says, is being put in administrative segregation. Wilson and the other inmates call it "the hole."

"There's no distraction, it's just you and the walls, everything goes through your mind," Wilson says. "Some people it doesn't affect very badly...But it's hard for me."

Wilson's always had a hard time taking direction. That's why he lands in the hole.

In 2005, he was diagnosed with attention deficit hyperactivity and bipolar disorders. "I flipped out," he recalls.

His parents hospitalized him after he threatened to kill himself. Psychiatrists put him on a series of medications that made him tired, incoherent and, sometimes, more angry.

He stopped taking the prescribed medications. In March 2007, Wilson, then 16, was caught with his girlfriend robbing vehicles in his hometown of Charlo. Witnesses tried to apprehend them. Wilson stabbed a man in the neck.

Prosecutors in Lake County charged Wilson with felony assault with a weapon. He pleaded guilty and was sentenced to a 90-day boot camp overseen by the Montana Department of Corrections and a six-year deferred sentence.

At this point, it would be easy to write off Wilson's story as typical: A messed-up kid screws up, hurts someone and gets put away, for his own good and others'. Yet it's what happens next, not just to Wilson but to many others like him, that raises some eyebrows about the fate of people with severe psychiatric problems in Montana's jails and prisons.

During the past three decades, as state psychiatric hospitals have curbed services, prisons have become home to a record number of mentally ill people. Of the 2,490 people in custody with the Montana DOC, 703, or 28 percent, are taking psychotropic medications.

Experts say prisons and jails simply aren't equipped to handle people with severe mental illness. Many contend that Wilson and other such inmates actually get worse in prison, leaving communities to foot an even larger tab for jails and hospitals. It also leaves people like Wilson more likely to commit another crime.

"They grabbed my meds"

In the months before Colton Wilson was slated to attend boot camp at the Treasure State Correctional Training Center, in 2009, he was prescribed three drugs: Lamictal, a mood stabilizer; Abilify, an antipsychotic; and Vyvanse, a stimulant.

The drugs worked. His mother, who had always gone out of her way to fend off her son's mood swings and paralyzing fear, was shocked. "It took almost a year and a half to get all of the pieces of the puzzle put together," Donna Wilson says. "Once we got to that point—night and day difference with this kid."

The judge who presided over Colton's case ordered that he take the medications while at Treasure State. Colton's nurse practitioner warned boot camp staff that Colton wouldn't make it through the Training Center if he didn't stay on the medications.

Colton's mother filled his backpack with family photos, a Bible and his prescriptions. The family drove Colton to Missoula. He was then transported to the camp, at Deer Lodge. Colton remembers that day. "They grabbed my meds and my Bible and shackled me up and we hit the road," he says.

In a lawsuit filed in February against the Treasure State Correctional Training Center, the DOC and the state, the family argues that Treasure State employees withheld Colton's medications for nearly a week.

The suit alleges that six days after Colton arrived at Treasure State, DOC psychiatrist Dr. David Schaefer prescribed Abilify but didn't approve the other drugs.

Schaefer did not respond to the Independent's request for comment. The DOC, citing pending litigation, declined to comment on the specifics of Colton's case.

Colton again became combative. He called the guards names. His behavior got him kicked out of boot camp and a subsequent DOC program. The court rescinded his plea deal and he was re-sentenced to 20 years in DOC custody, with 15 suspended.

The Wilsons' suit contends that the DOC's failure to provide prescribed medications for Colton violated his constitutional right to receive adequate medical care while incarcerated. "It's just like if you have someone who's a diabetic...and they need insulin, it's a serious medical condition," says Colton's Missoula attorney, Terance P. Perry, of Datsopolous, MacDonald & Lind.

Colton would not be incarcerated today had he been given his medication, his family argues.

His case is similar to those in two other lawsuits filed since 2000, which allege that mentally ill inmates were punished with increasing severity because they didn't receive proper mental health treatment.

In 2003, the Montana Supreme Court issued a sharply worded opinion against the DOC for its treatment of mentally ill prisoner Mark Edward Walker. Last year, a district judge intervened on behalf of a lawsuit filed by the ACLU; that suit involved Raistlen Katka, a mentally ill inmate who, as a minor, had been placed in administrative segregation in the high-security unit at Montana's Men's State Prison. Court documents in both cases allege the DOC violated constitutional protections against cruel and unusual punishment. Both Walker and Katka made suicide attempts while in custody.

The problem, says National Association on Mental Illness Montana Executive Director Matt Kuntz, is that prisons are designed to curb the bad behavior of rational people. The premise may seem simple: Behave, and you don't get in trouble. But people with serious mental illness don't always think rationally. There's a tendency to act out, which, in a prison setting, can lead to progressively harsher punishments.

"They commit crimes for different reasons than people who don't have serious mental illnesses," Kuntz says. "It's a disruption of neural circuits. That affects how they think, feel and act."

Kuntz says stories like Wilson's and those of other Montana inmates reflect a system that's ill equipped to handle the complexities of mental illness. "As long as the prisons are a place that we rely on to house our mentally ill, the Department of Corrections is going to fail," he observes. "It's like asking someone to hold water with a strainer—they don't have the right tools...Eventually somebody, and maybe it's going to be the Wilsons, is going to make the state of Montana pay for it."

"We definitely have a problem here"

The details of Colton Wilson's case are worth a closer look, if only to understand how such a person falls through the cracks in Montana's corrections system.

His mother, Donna Wilson, sensed something was wrong with her youngest son early. "He was just temperamental and very emotional," she says. "It was real hard to settle him down."

Colton slept in his parents' bed many nights. It helped alleviate the little boy's anxiety. She home schooled him, breaking lessons into bite-sized increments, sometimes just 15 minutes. But his moods worsened. Colton was cited for being a minor in possession of alcohol and for possession of dangerous drugs. Fights at home escalated. He accused his mom of trying to poison him.

Colton started Saint Ignatius High School in 2004, where he was aggressive toward other students and prone to angry outbursts. A school counselor asked to meet with the family. "She was very kind," Donna recalls. "She said, 'Oh, Donna, you've got to get him into Ronan Mental Health, we definitely have a problem here. I can see it.'"

In 2005, Colton was diagnosed with ADHD and oppositional defiant disorder. That year he was hospitalized twice for his threatening and self-destructive behavior. During the second hospitalization, in 2005, Saint Patrick Hospital diagnosed the teenager with bipolar disorder.

They sent Colton to a residential treatment center in Utah. He went through neurobehavioral testing. He saw psychiatrists and nurse practitioners.

Donna was dumbfounded. "I really didn't know anything about mental health," she says. "I thought he was a temperamental kid, I can't control him. He's a good boy, but yet he's a bad boy."

After Colton was charged with stabbing the man in Charlo, the Wilsons worked desperately to stabilize him. Donna read everything she could find about bipolar disorder. She made phone calls to treatment programs that had months-long waiting lists. They sent him to another treatment center, this time in Idaho.

Donna says no combination of drugs, confinement or encouragement seemed to work. "We were left having to deal with this very difficult psychiatric case on our own."

That's why the Wilsons were so pleased when Colton responded to the three medications prescribed by Missoula psychiatric nurse practitioner Kiely Howard. (Howard declined to comment for this article, citing privacy constraints.)

It made it all the more devastating to see Colton again fall apart in DOC custody. Donna could only watch in shock as the judge revoked his plea agreement and sentenced him to more incarceration.

Colton was put in the Montana State Prison at Deer Lodge. Donna told mental health staff there that Colton needed his full complement of medicines to function, but her pleas seemed not to matter, she says. She was especially frustrated when Schaefer, the DOC psychiatrist, called her in January 2010. He told Donna that Colton had antisocial personality disorder, which, unlike bipolar disorder, is not commonly thought treatable.

Schaefer told her that he saw no evidence of bipolar disorder or ADHD, she says. He cited prison safety concerns when saying that the Vyvanse Colton was taking, an amphetamine, would not be prescribed. Instead, he gave Colton the antidepressants Celexa and Wellbutrin.

Donna says the drugs caused Colton to unravel further. He threatened a guard and was written up for getting jailhouse tattoos. DOC put him in the Maximum Security Unit. "He ends up in isolation," Donna says. "He was totally freaking gonzo."